Assignment task:
67 year old Caucasian male (5'8", 212 lbs) with a medical hx significant CHF, CAD, HTN, and hyperlipidemia presents with ~8 days of URI symptoms - nasal congestion, rhinorrhea, and cough. PO intake reported as declined d/t early satiety, but no reported wt changes. RVP upon admission +COVID-19. Pt respiratory status significantly declines within 48 hours of admission and requires transition to BiPAP. SLP reports he is no longer safe for PO intake and assigns NPO status.
Labs upon assessment: BP 138/96, RR 38, Na 147 mmol/L, K 3.6 mmol/L, Cl 106 mmol/L, CO2 14 mmol/L, BUN 30 mg/dL, Cr 2.3 mg/dL, Glucose 235 mg/dL; pH 7.49, pCO2 31 mmHg, HCO3 27.1 mEq/L.
1. Calculate BMI
2. Does he meet criteria for malnutrition? T or F
3. Does the pt meet criteria for obesity? T or F
4. What class?
5. Which primary acid-base disorder applies?
6. What clinical symptom is impacting his acid-base balance?
7. What compound is he losing leading to alkalosis?
8. What physiological compensatory mechanism do you anticipate?
9. Does he meet criteria for hypernatremia? T or F
10. Does he meet criteria for hyperkalemia? T or F
11. Does he meet criteria for hyperchloremia? T or F
12. Which route of nutrition support would you recommend for this patient? EN, TPN, or Nutrition support is not indicated.